Despite effort, opioid deaths still climbing in Mass.
The death toll from opioids in Massachusetts continues to rise unabated despite months of intensifying efforts to combat the substance abuse crisis, new data revealed Wednesday.
Estimates from the state Department of Public Health show that during the first half of 2015, the number of deaths from opioid overdoses — 684 — increased about 6 percent from the same period last year.
“It correlates with what we’re hearing anecdotally,” said Vic DiGravio, president of the Association for Behavioral Healthcare, which represents community-based treatment providers. Demand for care remains high, he said, and treatment providers have recently been encountering a new phenomenon — overdoses occurring in treatment programs’ waiting rooms and in the neighborhoods right outside their doors.
Governor Charlie Baker said in a statement that legislation he has proposed, which would limit prescriptions for painkillers and allow hospitals to force treatment on certain substance users, adds to the arsenal being employed to combat the epidemic.
“This data reminds us that we need to use every tool at our disposal to fight back against this public health crisis, which continues to have a drastic impact in all corners of the Commonwealth,” he said.
The health department has confirmed that 1,089 people died of opioid overdoses in 2014, based on information available as of Oct. 15. But that record tally is likely to climb higher: Once the medical examiner has finalized death investigations, it is expected that an additional 136 to 199 overdose fatalities will be confirmed for last year.
Those 1,089 deaths represent a 63 percent increase over 2012 and a 20 percent jump over 2013.
The updated data are available at mass.gov/stopaddiction , with 2014 numbers for cities, towns, and counties. The state plans to release such information quarterly.
Dr. Monica Bharel, commissioner of the Department of Public Health, said that such information is “a critical instrument” in fighting the opioid abuse. “We know that this epidemic remains a deadly reality for too many,” she said in a statement, “and our treatment of it must remain a top priority.”
The department released the data six days after Baker proposed his legislation intended to address the problem. His proposals are already facing challenges from legislators and medical groups.
Under Baker’s legislation, hospitals could hold people with substance use problems against their will for three days, raising civil liberties concerns. It would also require that medical professionals dispense no more than three days’ worth of pills the first time they see a patient, a provision that prompted objections from groups representing physicians and dentists.
Earlier this year, Baker convened an Opioid Working Group made up of people involved in treatment, recovery, and law enforcement. After holding hearings around the state, the group in June made 65 recommendations, including a recommendation that clinicians be allowed to hold people involuntarily to conduct an assessment.
Many of its proposals are being implemented, including adding 194 treatment beds in five communities and redesigning the Prescription Monitoring Program, a database of every controlled-substance prescription dispensed in the state.
The Public Health Council, an appointed board of physicians, public health specialists, and consumer advocates, approved regulations on Wednesday requiring pharmacies to report controlled substance prescriptions to that database at least once every 24 hours, or by the end of each business day for pharmacies that are not open every day. Previously, pharmacies had to report only once a week.
The monitoring program is considered a vital tool for detecting when patients are obtaining drugs from multiple providers or multiple pharmacies, a sign of overuse. But doctors had complained that week-old information was unhelpful.
The council also received new data on prescriptions for controlled substances, such as painkillers, derived from the monitoring program. It showed that prescriptions had declined slightly in 2014, returning to 2011 levels. But the numbers remain staggering: In a state with 6.7 million people, 4.4 million opioid prescriptions — including 240 million pills, capsules, or tablets — were dispensed in 2014.
The data offered one glimmer of hope: In 2014, the number of people obtaining opioid prescriptions from six or more prescribers and pharmacists was about half the number in 2009.
The Public Health Council also approved an emergency change in regulations governing Section 35, the provision of state law that allows involuntary civil commitment of people with substance use disorders. Currently, people committed to treatment under Section 35 go to one of two designated treatment centers with 198 beds, or to one of two prisons if those beds are full.
The emergency change would allow other treatment centers to accept civilly committed patients, meaning they would not have to go to prison.
“This is just one tool in the toolbox for addressing opioid overdose,” said Erica Piedade, director of quality assurance and licensing at the state Bureau of Substance Abuse Services.
Correction: Because of a reporting error, a previous version of this story gave incorrect information about the recommendations of the governor’s Opioid Working Group. The group did recommend that clinicians be allowed to hold substance users involuntarily for an assessment.